POS1102 THE PREVALENCE OF INFLAMMATORY BACK PAIN IN PATIENTS WITH SKIN PSORIASIS WITHOUT PSORIATIC ARTHRITIS. DATA FROM DERMATOLOGICAL REAL-WORLD SETTING.
Authors: N. Pereverzina, L. Kruglova, T. Korotaeva, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background Psoriasis (PsO) is an inflammatory disease associated with psoriatic arthritis (PsA). PsA affects peripheral and axial joints 1,2 . Psoriasis can precede the onset of PsA by approximately 3 to 8 years, axial involvement often undiagnosed 3 . There are limited data about the prevalence of inflammatory back pain (IBP) in PsO patients (pts) without clinical symptoms of PsA 4 . Objectives To study the prevalence of IBP in PsO pts without PsA symptoms Methods 108 PsO pts without PsA over a 10-month period (March 2021 to December 2021) were incluided. Participants filled out a questionnaire on IBP. Additionaly the prevalence of stiffness in the back and neck was estimated. IBP was defined as an affirmative answer to the question ‘Did you suffer from low back pain for ≥3 months?’ and IBP criteria was based on criteria ASAS (the ASsessment in Ankylosing Spondylitis) and was confirmed if at least 3 out of the following 4 criteria were present: (a) onset before age 40, (b) insidious onset, (c) improvement with exercise, (d) associated with morning stiffness Results It was found that more than 40% of patients complained of pain or stiffness in the back. Stiffness and pain in the neck were observed in every fourth patient on average. Of those patients who complained of pain in the back or neck, 37% noted that they had pain at rest (when they get up in the morning or lie down for a long time), and 21.3% had inflammatory pain at night (when patients are forced to woke up, they needed to do exercises) (Table 1). It was found that the risks of developing spondylitis with neck pain, neck stiffness, back pain, back stiffness were higher in 4,549 times (95% CI [1,720; 12,031]), in 19,444 times (95% CI [6,480; 58,343]) 15 times (95% CI [4.646; 48.427]) and 34.857 times (95% CI [7.583; 160.230]), respectively. Conclusion IBP was found in more than 40% PsO patients. Every fourth PsO patients complained of stiffness and pain in the neck. The presence of these symptoms significantly increased the risk of developing PsA with spondylitis. The presence of IBP should be taken into account for early diagnosis of PsA in the dermatological practice. References [1]Gladman DD. Axial disease in psoriatic arthritis. Curr Rheumatol Rep. 2007 Dec;9(6):455-60. doi: 10.1007/s11926-007-0074-2. [2]Chandran V, Barrett J, Schentag CT, Farewell VT, Gladman DD. Axial psoriatic arthritis: update on a longterm prospective study. J Rheumatol. 2009 Dec;36(12):2744-50. doi: 10.3899/jrheum.090412. [3]Queiro R, Belzunegui J, González C, De DJ, Sarasqueta C, Torre JC, Figueroa M. Clinically asymptomatic axial disease in psoriatic spondyloarthropathy. A retrospective study. Clin Rheumatol. 2002 Feb;21(1):10-3. doi: 10.1007/s100670200003. [4]Gottlieb AB, Merola JF. Axial psoriatic arthritis: An update for dermatologists. J Am Acad Dermatol. 2021 Jan;84(1):92-101. doi: 10.1016/j.jaad.2020.05.089. Disclosure of Interests Natalia Pereverzina: None declared, Larisa Kruglova: None declared, Tatiana Korotaeva Speakers bureau: Pfizer, MSD, AbbVie, Novartis-Sandoz, JSC Biocad, Janssen, UCB, Alexander Lila: None declared